Chen Z, Maricic M, Lund P, Tesser J, Gluck O
Arizona Prevention Center, University of Arizona, Tucson 85716, USA.
Osteoporos Int. 1998;8(5):423-7. doi: 10.1007/s001980050086.
In February 1997, Hologic supplied new software to all QDR dual-energy X-ray absorptiometry (DXA) machines replacing the previous femoral normative reference database with the NHANES III normative data. In addition to changing the normative database (and therefore T-scores) for all regions of the hip, the new software has changed the primary region of interest from the femoral neck to the total hip. In the present study we examined how these changes influence the densitometric diagnosis of osteoporosis in a large clinical referral population (n = 2311, mean age 62.7 years). The patients had spine and hip DXA performed at either of two centers using a Hologic QDR-2000 over a 4-year period. T-scores were derived for each patient using both previous and current young normal reference databases. Intraindividual differences in T-scores were calculated. The prevalence of osteoporosis based on the two normative databases and the difference between the prevalence was calculated for each skeletal site. The average paired difference between current and previous T-scores at femoral neck is 0.64, the difference increasing with age. Using the new normative database, the percentage of osteoporotic patients decreases from 49% of all patients at the femoral neck to 28% at the femoral neck and 20% at the total hip. In conclusion, the densitometric diagnosis of osteoporosis will be affected in a significant proportion of women as a result of the implementation of the new hip normative database supplied by Hologic. Whether this will translate into fewer patients being treated remains to be seen.
1997年2月，Hologic公司为所有QDR双能X线吸收仪（DXA）提供了新软件，用美国国家健康与营养检查调查（NHANES）III的标准数据取代了先前的股骨标准参考数据库。除了改变髋部所有区域的标准数据库（以及因此改变T值）外，新软件还将主要感兴趣区域从股骨颈改为全髋。在本研究中，我们调查了这些变化如何影响一大群临床转诊人群（n = 2311，平均年龄62.7岁）中骨质疏松症的密度测定诊断。在4年期间，患者在两个中心之一使用Hologic QDR - 2000进行了脊柱和髋部DXA检查。使用先前和当前的年轻正常参考数据库为每位患者得出T值。计算了个体内T值的差异。计算了基于这两个标准数据库的骨质疏松症患病率以及每个骨骼部位患病率之间的差异。股骨颈当前和先前T值的平均配对差异为0.64，该差异随年龄增加。使用新的标准数据库，骨质疏松症患者的百分比从股骨颈所有患者的49%降至股骨颈的28%和全髋的20%。总之，由于Hologic公司提供的新髋部标准数据库的实施，相当一部分女性的骨质疏松症密度测定诊断将受到影响。这是否会导致接受治疗的患者减少还有待观察。
